Unintentional drug overdose has become a grave and sustained public health burden in the US. 1 The US Centers for Disease Control and Prevention (CDC) defines unintentional drug overdose as occurring "…when no harm is intended." 2(p1) and inclusive of "…overdoses resulting from drug misuse, drug abuse, and taking too much of a drug for medical reasons." 2(p1) Adult decedents have been the focus of most overdose mortality reports, despite the fact that adolescents (aged 10-19 years) and young people (aged 10-24 years) are increasingly dying of unintentional drug overdose. 3 This troubling trend requires further study, given that adolescents and young people are deprived of many more years of work, community life, and family life than are older individuals dying of unintentional drug overdose.To our knowledge, no prior study has assessed unintentional drug overdose mortality among adolescents and young people in years of life lost (YLL). YLL is an epidemiologic descriptor that gives weight to deaths among the young. 4 YLL analysis has the potential to provide important context to the overdose crisis by better representing what is meant to society by the loss of adolescents and young people to unintentional drug overdose. The present work aimed to fill this important gap in the literature by calculating unintentional drug overdose YLL in this vulnerable population.

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To the Editor In their study of fatal drug overdoses among young people aged 10 to 24 years, Hall and colleagues 1 report 21 689 deaths from 2015 to 2019, which resulted in 1.23 million years of lost life (YLL). This averages to 57 YLL per overdose death, a devastating statistic.The authors' life expectancy data source, the Social Security Administration Period Life Table, did not include information on race; therefore, race-specific YLLs were not provided. However, we can be reasonably sure that the burden of YLL is rapidly changing in ways that are closely tied to race. From 2015 to 2020, the age-adjusted drug overdose death rate for young White male individuals increased by 37%, rising from 9.1 to 12.5 per 100 000 people. By contrast, the rate quadrupled for young Black male individuals, rising from 2.7 to 10.8. Similarly, for young White female individuals, the overdose death rate increased by 41%, rising from 4.1 to 5.8. For young Black female individuals, the rate more than tripled, rising from 1.4 to 4.6. 2 Young Black individuals have experienced a staggering increase in overdose deaths and YLL since 2015, with rates now approximating those of young White individuals. A better understanding of the race-specific drivers of overdose mortality among young people is an urgent priority.

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